Pt Northwest Of Longview, INC
Physical Therapist in Lacey, WA. Organization (NPI-2).
NPI number1508208596
StatusActive
Last updated in NPPESOct 1, 2013
Details
- NPI
- 1508208596
- Entity type
- Organization (NPI-2)
- Legal business name
- Pt Northwest Of Longview, INC
- Organization subpart
- No
- Enumeration date
- Jul 19, 2013
- Last updated
- Oct 1, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Other names
- Capitol Physical Therapy (Doing Business As)
Practice location
4770 Yelm Hwy SeLacey, WA 98503-4986
Phone 360-491-6074
Mailing address
1560 3rd AveLongview, WA 98632-3229
Phone 360-423-9535 · Fax 360-414-9284
Authorized official
Daniel Lee Hughes
Owner/President
3604239535
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